CAR-T Meeting 2024 | Predicting outcomes in patients with R/R MM undergoing CAR T-cell therapy: the MyCARe model
Nico Gagelmann, MD, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, discusses a study that identified predictors of outcomes following CAR T-cell therapy using a cohort of 269 patients with relapsed/refractory (R/R) multiple myeloma (MM). Independent predictors of early relapse or progression included high-risk cytogenetics, the presence of extramedullary disease or plasma cell leukemia at the time of lymphodepletion, and ferritin levels. These findings were used to develop the Myeloma CAR-T Relapse (MyCARe) model, which was subsequently validated and may now be used to determine the optimal timing of CAR T-cell infusion in patient-specific subgroups. This interview took place at the EBMT-EHA 6th European CAR T-cell Meeting in Valencia, Spain.
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Transcript (edited for clarity)
So the study we will present, actually in one hour here at the EBMT-EHA CAR-T meeting, is a large cohort of 269 patients who received CAR T-cell therapy from Europe but also from the US. And what we identified were four main predictors of outcome: disease-specific, treatment-specific, and inflammation-specific. And we identified the presence of extramedullary disease and plasma cell leukemia at the time of CAR-T infusion, as well as high-risk cytogenetics, together with the lenalidomide refractoriness status, and a high ferritin at the time of lymphodepletion...
So the study we will present, actually in one hour here at the EBMT-EHA CAR-T meeting, is a large cohort of 269 patients who received CAR T-cell therapy from Europe but also from the US. And what we identified were four main predictors of outcome: disease-specific, treatment-specific, and inflammation-specific. And we identified the presence of extramedullary disease and plasma cell leukemia at the time of CAR-T infusion, as well as high-risk cytogenetics, together with the lenalidomide refractoriness status, and a high ferritin at the time of lymphodepletion. These characteristics clearly predicted the outcome after CAR-T, especially for early relapse, which is a clinical unmet need for patients with myeloma who receive CAR-T therapy.
And these risk factors, they [were used to] build a model, what we call now the MyCARe model- the myeloma CAR-T relapse model. This could clearly identify three risk groups: low, intermediate, and high risk for early relapse, but also worse progression-free survival and overall survival.
So, this model now was trained in the European cohort and validated in the US cohort. And this model must be validated prospectively and can also help with patient selection for patients who benefit the most from CAR-T or maybe for patients who need maintenance consolidation therapy, specifically early after CAR-T therapy.
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